Multidetector computed tomography in the evaluation of hereditary multiple exostoses

• This article reviews the role of multidetector computed tomography (MDCT) in the evaluation of hereditary multiple exostoses.
• MDCT scanning technique, clinical manifestation, 3D visualization techniques, typical MDCT appearances, and differential diagnostic considerations are outlined.
• The usefulness of MDCT in the assessment of emergent and non-emergent HME-complications is illustrated.

Hereditary multiple exostoses (HME) is an autosomal dominant disorder characterized by the formation of multiple osteochondromas. Because of its superior soft tissue contrast and absence of ionizing radiation, magnetic resonance imaging is the first choice imaging technique for the evaluation of complex lesions and complications related to HME. However, multidetector computed tomography (MDCT) also can be of value in the evaluation of patients with HME, which is reviewed in this article. Topics outlined are low-dose MDCT technique, 3-dimensional visualization techniques, typical MDCT appearances, differential diagnostic considerations, and the usefulness of MDCT in the assessment of emergent and non-emergent complications related to HME, among which spinal cord compression, pneumothorax and hematothorax, pseudoaneurysms, fractures, growth disturbances, chondrosarcoma transformation, and muscular and peripheral nerve involvement.